This study aims to evaluate and compare patient satisfaction and prosthetic complications between two types of prostheses: milled bar and screw-retained prostheses, used for supporting maxillary subperiosteal implants. Patients requiring maxillary rehabilitation using subperiosteal implants will be randomly assigned to receive either a milled bar-retained prosthesis or a screw-retained prosthesis. Patient satisfaction and any prosthetic complications will be clinical assessed and followed up over a one-year period to determine which prosthetic design offers better clinical outcomes and patient experience.

Patients enrolled in this randomized clinical trial will undergo surgical placement of maxillary subperiosteal implants. Following the healing period, patients will be allocated into two treatment groups. Group 1 will receive a milled bar-retained prosthesis, while Group 2 will receive a screw-retained prosthesis. Baseline data and clinical parameters will be recorded. Throughout the one-year follow-up period, patient satisfaction will be evaluated using standardized questionnaires or visual analog scales (VAS). Additionally, prosthetic complications-such as screw loosening, fracture, or bar-related issues-will be closely monitored and documented at regular follow-up intervals to comprehensively compare the two restorative modalities.

Inclusion Criteria

• Severe atrophied maxillary ridge (Residual bone height < 4mm on CBCT) with the presence of adequate bone volume in the maxilla to support subperiosteal implants.
• Willing to attend quarterly follow-ups.
• No previous subperiosteal implant history.

Exclusion Criteria

• Systemic conditions contraindicating implant therapy.
• Poor oral hygiene or ongoing periodontal disease.
• Patients who have received hybrid restorations (i.e., a combination of bar and multi-unit systems).